Vital Signs Foundations

Vital signs provide a baseline and reveal trends. They must be interpreted with appearance, complaint, history, environment, age, medications, and treatment. A single normal value does not cancel a concerning presentation, and a single abnormal value should be confirmed when practical without delaying needed care.

Understand systolic and diastolic pressure, cuff sizing, arm position, gauge visibility, bulb and valve control, palpated estimation, and auscultated measurement. A cuff that is too small can read high; one that is too large can read low. Movement, talking, poor positioning, rapid deflation, and noise can reduce accuracy.

Pulse assessment includes rate, rhythm, and strength. Respiratory assessment includes rate, rhythm, depth, effort, chest movement, speech, and associated sounds or signs. Counting should be long enough to capture irregularity. Respirations are often under-measured because providers announce the count or guess.

Pulse oximetry estimates oxygen saturation but can be affected by motion, poor perfusion, sensor placement, nail coverings, dyshemoglobins, and device limitations. Skin color, temperature, and moisture add perfusion context. Glucose values must be connected to symptoms and meter quality. Temperature route and device affect interpretation.

Repeat vital signs after an intervention, a change, or according to local expectations. Record the actual value, time, method when relevant, and patient context. Trends such as rising respiratory rate, falling mental status, or improving work of breathing often matter more than a single isolated number.